An approach for half-life extension and activity preservation of an anti-diabetic peptide drug based on genetic fusion with an albumin-binding aptide

Although the peptide, exenatide, has been widely used as a drug for the treatment of type 2 diabetes, its short plasma half-life requires frequent subcutaneous injection, resulting in poor patient compliance in addition to side effects such as infection at the sites of injection. Here, we report a novel long-acting fusion peptide comprising exenatide and a human serum albumin (HSA)-binding aptide. A phage display screen of a library of aptides, yielded an HSA-specific aptide (APT(HSA)) that bound HSA with a K-d of 188 nM. The recombinant fusion peptide comprising exenatide and APT(HSA) (exenatide-APT(HSA)) was expressed in Escherichia coli and purified by affinity and size-exclusion chromatography. The resulting exenatide-APTHSA fusion peptide showed glucose-induced insulin secretion activity similar to that of native exenatide when tested in vitro using the INS-1 cell line. A pharmacokinetic analysis of exenatide-APT(HSA) after subcutaneous administration revealed a 4-fold longer plasma half-life (1.3 vs. 0.35 h) compared with exenatide. Furthermore, exenatide-APT(HSA) showed significantly improved anti-hyperglycemic effects in oral glucose tolerance tests and enhanced hypoglycemic effects compared with exenatide in a db/db type 2 diabetes mouse model. These results suggest that the exenatide-APT(HSA) fusion peptide could be used as a potential anti-diabetic agent for the treatment of type 2 diabetes.